Objective:To investigate the correlation between the neoadjuvant rectal (NAR) score and long-term survival in patients with locally advanced rectal cancer who have undergone neoadjuvant chemoradiotherapy.Methods:Clinical and pathological data of 487 patients diagnosed with rectal adenocarcinoma from October 2004 to April 2014 at Sun Yat-sen University Cancer Center who had received neoadjuvant chemoradiotherapy were retrospectively analyzed and the impact of NAR score on prognosis studied. Disease-free-survival (DFS) was calculated by the Kaplan-Meier method and survivals compared using the log-rank test. Cox models were used for univariate and multivariate analyses. Receiver operating characteristic curves were utilized to evaluate the predictive capability of NAR and tumor regression grade scores for the risk of 10-year postoperative recurrence and metastasis. The Delong test was employed to compare the diagnostic performance of the two scores.Results:Of the 487 patients included in the study, 166 were men (34.1%). The median age was 56 years (interquartile range [IQR]: 46–63). All patients completed adequate preoperative chemoradiotherapy and underwent R0 resection.The median interval between the end of chemoradiotherapy and surgery was 51 days (IQR: 44–58). Post-chemoradiotherapy downstaging occurred in 329 patients (67.6%). Tumor regression grades (TRGs) were 1–2 in 246 patients (50.5%) and 3–4 in 241 patients (49.5%). A total of 394 patients (80.9%) received postoperative chemotherapy. NAR scores were <8 in 182 patients (37.4%), 8–16 in 180 (37.0%), and >16 in 125 (25.6%). The median follow-up time was 111.5 months (IQR: 70.7–133.7 months). One hundred and thirteen patients died of rectal cancer, among whom 13 patients developed local recurrence, 88 patients developed distant metastasis, and 12 patients had unknown recurrence patterns. The 10-year DFS and overall survival rate of f the whole group were 68.9% and 71.5% respectively. The 10-year DFS rates for patients with NAR scores <8, 8–16, and >16 were 85.1%, 80.5%, and 66.4%, respectively ( P<0.001). Multivariate analyses revealed that the Dixon operation (HR=0.606, 95%CI: 0.408–0.902, P=0.014), and >16 (HR=2.569, 95%CI: 1.559–4.233, P<0.001) were independent predictors of the 10-year DFS of patients with locally advanced rectal cancer ( P<0.05 for all). In the entire patient cohort, the AUC of the receiver operating characteristic curve for NAR score predicting 10-year recurrence and metastasis was 0.67 (95%CI: 0.62–0.72), whereas the AUC for TRG score was 0.54 (95%CI: 0.49–0.60). The two scores differed significantly in accuracy ( Z=-4.06, P<0.001), the NAR score being a significantly better predictor of risk of 10-year recurrence and metastasis than the TRG score. Conclusion:The NAR score is a reliable predictor of 10-year DFS in patients with locally advanced rectal cancer who have undergone neoadjuvant chemoradiotherapy followed by curative surgery.

Objective By using CiteSpace-based visualization analysis to investigate the main research contents,research frontiers,author cooperation network and institutional cooperation network of traditional Chinese medicine(TCM)treatment for patients after receiving percutaneous coronary intervention(PCI)so as to provide reference for the TCM diagnosis,treatment and research of patients after receiving PCI.Methods A computerized retrieval of academic papers concerning TCM treatment of patients after receiving PCI from CNKI,VIP and Wanfang databases was conducted.The retrieved literature materials were input into NoteExpress software to make the literature screening and the data cleaning.CiteSpace software was used to analyze the key words,authors,institutions,etc.Results A total of 1 708 articles were obtained;the number of published articles in 2020 was the largest,which was up to 137 articles.The core authors accounted for 4.37％of the total number of authors who had written articles,but no core author group had been formed yet.Liaoning province of China was the region where the number of published articles was the largest,and there was no effective collaboration network between different areas.The cluster analysis yielded 25 clusters,448 key nodes and 1 266 lines.The main cluster results were coronary heart disease,acute coronary syndrome,acute myocardial infarction,restenosis,etc.The analysis of emergent words(i.e.the suddenly increased frequency of a certain key word in a certain period)yielded 24 emergent words,including syndrome differentiation of TCM,ginseng peony oral liquid,cardiac rehabilitation,etc.Conclusion The main research contents of TCM treatment for patients after PCI include syndrome differentiation of TCM,etiology and pathogenesis,clinical trials,etc.Postoperative pathological phenomena such as restenosis are the research difficulties in this field,and anxiety,dual-mind TCM,and cardiac rehabilitation are the current research hotspots.TCM has definite efficacy in promoting the recovery of cardiac function after PCI,in reducing the incidence of postoperative events such as restenosis,and in improving anxiety and depression.

Objective:To investigate the correlation between the neoadjuvant rectal (NAR) score and long-term survival in patients with locally advanced rectal cancer who have undergone neoadjuvant chemoradiotherapy.Methods:Clinical and pathological data of 487 patients diagnosed with rectal adenocarcinoma from October 2004 to April 2014 at Sun Yat-sen University Cancer Center who had received neoadjuvant chemoradiotherapy were retrospectively analyzed and the impact of NAR score on prognosis studied. Disease-free-survival (DFS) was calculated by the Kaplan-Meier method and survivals compared using the log-rank test. Cox models were used for univariate and multivariate analyses. Receiver operating characteristic curves were utilized to evaluate the predictive capability of NAR and tumor regression grade scores for the risk of 10-year postoperative recurrence and metastasis. The Delong test was employed to compare the diagnostic performance of the two scores.Results:Of the 487 patients included in the study, 166 were men (34.1%). The median age was 56 years (interquartile range [IQR]: 46–63). All patients completed adequate preoperative chemoradiotherapy and underwent R0 resection.The median interval between the end of chemoradiotherapy and surgery was 51 days (IQR: 44–58). Post-chemoradiotherapy downstaging occurred in 329 patients (67.6%). Tumor regression grades (TRGs) were 1–2 in 246 patients (50.5%) and 3–4 in 241 patients (49.5%). A total of 394 patients (80.9%) received postoperative chemotherapy. NAR scores were <8 in 182 patients (37.4%), 8–16 in 180 (37.0%), and >16 in 125 (25.6%). The median follow-up time was 111.5 months (IQR: 70.7–133.7 months). One hundred and thirteen patients died of rectal cancer, among whom 13 patients developed local recurrence, 88 patients developed distant metastasis, and 12 patients had unknown recurrence patterns. The 10-year DFS and overall survival rate of f the whole group were 68.9% and 71.5% respectively. The 10-year DFS rates for patients with NAR scores <8, 8–16, and >16 were 85.1%, 80.5%, and 66.4%, respectively ( P<0.001). Multivariate analyses revealed that the Dixon operation (HR=0.606, 95%CI: 0.408–0.902, P=0.014), and >16 (HR=2.569, 95%CI: 1.559–4.233, P<0.001) were independent predictors of the 10-year DFS of patients with locally advanced rectal cancer ( P<0.05 for all). In the entire patient cohort, the AUC of the receiver operating characteristic curve for NAR score predicting 10-year recurrence and metastasis was 0.67 (95%CI: 0.62–0.72), whereas the AUC for TRG score was 0.54 (95%CI: 0.49–0.60). The two scores differed significantly in accuracy ( Z=-4.06, P<0.001), the NAR score being a significantly better predictor of risk of 10-year recurrence and metastasis than the TRG score. Conclusion:The NAR score is a reliable predictor of 10-year DFS in patients with locally advanced rectal cancer who have undergone neoadjuvant chemoradiotherapy followed by curative surgery.

Objective:To synthesize new bakuchiol aminoguanidine derivatives and test their effect on viability and apoptosis of human triple-negative breast cancer(TNBC)cells.Methods:Two bakuchiol derivatives 1 and 2 were obtained by formylation and Shiff base reaction of bakuchol.The structures of derivatives 1 and 2 were identified by 1H-NMR,13C-NMR,and high-resolution electrospray ionization mass spectrometry(HR-ESI-MS)analysis.Human TNBC MDA-MB-231 cells were treated with bakuchiol and its derivatives and cell viability was measured by MTT assay.Apoptosis was detected by fluorescence microscopy and flow cytometry with Annexin V-FITC/PI staining.The expressions of apoptosis-related proteins were analyzed with Western blotting.The JC-1 and reactive oxygen species(ROS)assay kits were used to determine the effect of new bakuchiol derivatives on mitochondrial function.Results:Based on spectroscopic analysis,a new bakuchiol schiff base derivative was elucidated as 2-{(E)-5-[(S,E)-3,7-dimethyl-3-vinylocta-1,6-dien-1-yl]-2-hydroxylbenzylidene}hydrazine-1-carboximidamide(derivative 2).Bakuchiol and its derivatives 1 and 2 all showed cytotoxic activity against the MDA-MB-231 cells.Derivative 2 exhibited the most potent cytotoxic activity to MDA-MB-231 cell with IC50 of(13.11±1.09),(6.91±1.78),and(2.23±1.32)μmol/L after 24,48,and 72 h.It had low toxicity to normal mouse liver(AML-12)cells with IC50 of(31.23±1.58)μmol/L at 72 h.Fluorescence microscopy and flow cytometry demonstrated apoptosis in breast cancer cells after treating with derivative 2 in a concentration dependent manner.Western blotting showed that after derivative 2 treatment,the expression of apoptosis-related proteins cytochrome C,cleaving caspase-3 and Bax/Bcl-2 radio in MDA-MB-231 cells increased;in addition,apoptosis was associated with the decreased mitochondrial membrane potential and increased reactive oxygen species accumulation.Conclusion:The novel bakuchiol aminoguanidine derivative(derivative 2)is capable of inducing apoptosis in MDA-MB-231 cells,but has low toxicity to normal liver cells,suggesting that it may be used as a lead compound for an anti-TNBC agent.

Objective To observe the feasibility and safety of CT-guided fine-needle assisted localization for puncturing difficult lung or liver lesions.Methods Data of 30 patients with single difficult lung or liver lesion,i.e.lesion located at difficult part for puncturing or deep lesion with diameter of 0.5-2.0 cm who underwent CT-guided 22G needle assisted localization before puncturing were retrospectively analyzed.The success rate of fine-needle assisted localization,the success rate of the first-time puncturing and the occurrence of complications were recorded.Results Among 30 difficult lesions,there were 27 lung lesions and 3 hepatic lesions,with a mean diameter of(1.0±0.4)cm.Assisted localization of difficult lesions were successfully performed with 22G needle under CT guidance at the edge of lesion,1 cm adjacent to lesion or at the puncture path,with success rate of fine-needle assisted localization of 100%,and no obvious complication happened.The followed operations included preoperative localization of 14 lung nodules,biopsy of 10 lung nodules and 3 liver nodules,as well as microwave ablation of 3 liver nodules,with the success rate of the first-time puncturing of 100%.Mild pneumothorax was observed in 3 cases(3/27,11.11%)of difficult lung lesions after biopy.No other obvious complication occurred.Conclusion CT-guided fine-needle assisted localization for percutaneous puncturing difficult lung or liver lesions was feasible and safe.

OBJECTIVE: To investigate the clinical value of analgesia and sedation under bispectral index (BIS) monitoring combined with hydraulic coupled intracranial pressure (ICP) monitoring in severe craniocerebral injury (sTBI). METHODS: (1) A prospective self-controlled parallel control study was conducted. A total of 32 patients with sTBI after craniotomy admitted to the intensive care unit (ICU) of the First People's Hospital of Huzhou from December 2020 to July 2021 were selected as the research objects. ICP was monitored by Codman monitoring system and hydraulically coupled monitoring system, and the difference and correlation between them were compared. (2) A prospective randomized controlled study was conducted. A total of 108 sTBI patients admitted to the ICU of the First People's Hospital of Huzhou from August 2021 to August 2022 were selected patients were divided into 3 groups according to the random number table method. All patients were given routine treatment after brain surgery. On this basis, the ICP values of the patients in group A (35 cases) were monitored by Codman monitoring system, the ICP values of the patients in group B (40 cases) were monitored by hydraulic coupling monitoring system, and the ICP values of the patients in group C (33 cases) were monitored combined with hydraulic coupling monitoring system, and the analgesia and sedation were guided by BIS. The ICP after treatment, cerebrospinal fluid drainage time, ICP monitoring time, ICU stay time, complications and Glasgow outcome score (GOS) at 6 months after surgery were compared among the 3 groups. In addition, patients in group B and group C were further grouped according to the waveforms. If P₁ = P₂ wave or P₂ and P₃ wave were low, they were classified as compensatory group. If the round wave or P₂ > P₁ wave was defined as decompensated group, the GOS scores of the two groups at 6 months after operation were compared. RESULTS: (1) There was no significant difference in ICP values measured by Codman monitoring system and hydraulic coupling monitoring system in the same patient (mmHg: 11.94±1.76 vs. 11.88±1.90, t = 0.150, P = 0.882; 1 mmHg≈0.133 kPa). Blan-altman analysis showed that the 95% consistency limit (95%LoA) of ICP values measured by the two methods was -4.55 to 4.68 mmHg, and all points fell within 95%LoA, indicating that the two methods had a good correlation. (2) There were no significant differences in cerebrospinal fluid drainage time, ICP monitoring time, ICU stay time, and incidence of complications such as intracranial infection, intracranial rebleeding, traumatic hydrocephalus, cerebrospinal fluid leakage, and accidental extubation among the 3 groups of sTBI patients (P > 0.05 or P > 0.017). The ICP value of group C after treatment was significantly lower than that of group A and group B (mmHg: 20.94±2.37 vs. 25.86±3.15, 26.40±3.09, all P < 0.05), the incidence of pulmonary infection (9.1% vs. 45.7%, 42.5%), seizure (3.0% vs. 31.4%, 30.0%), reoperation (3.0% vs. 31.4%, 40.0%), and poor prognosis 6 months after operation (33.3% vs. 65.7%, 65.0%) were significantly lower than those in group A and group B (all P < 0.017). According to the hydraulic coupling waveform, GOS scores of 35 patients in the compensated group were significantly higher than those of 38 patients in the decompensated group 6 months after operation (4.03±1.18 vs. 2.39±1.50, t = 5.153, P < 0.001). CONCLUSIONS The hydraulic coupled intracranial pressure monitoring system has good accuracy and consistency in measuring ICP value, and it can better display ICP waveform changes than the traditional ICP monitoring method, and has better prediction value for prognosis evaluation, which can replace Codman monitoring to accurately guide clinical work. In addition, analgesia and sedation under BIS monitoring combined with hydraulic coupled ICP monitoring can effectively reduce ICP, reduce the incidence of complications, and improve the prognosis, which has high clinical application value.
Humans ; Intracranial Pressure ; Prospective Studies ; Monitoring, Physiologic/methods* ; Craniocerebral Trauma ; Analgesia ; Cerebrospinal Fluid Leak

3D printing technology has great advantages in small batch and personalized customization, so it has attracted much attention in the biomedical field. The consumables available for 3D printing include polymer, metal, ceramic and derived materials. Biomedical ceramics, with high melting point and poor toughness, are the most difficult materials to be used in 3D printing. The progress of 3D printing ceramic preparation process using ceramic powder, ceramic slurry, ceramic wire, ceramic film and other different raw materials as consumables are reviewed, and the surface roughness, size, density and other parameters of ceramics prepared by SLS, 3DP, DIW, IJP, SL, DLP, FDM, LOM and other different processes are compared. The study also summarizes the clinical application status of 3D printed bioceramics in the field of hard tissue repair such as bone tissue engineering scaffolds and dental prostheses. The SL ceramic additive manufacturing technology based on the principle of UV polymerization has better manufacturing precision, forming quality and the ability to prepare large-size parts, and can also endow bioceramics with better biological properties, mechanical properties, antibacterial, tumor treatment and other functions by doping trace nutrients and surface functional modification. Compared with the traditional subtractive manufacturing process, the bioceramics prepared by 3D printing not only have good mechanical properties, but also often have better biocompatibility and osteoconductivity.
Bone and Bones ; Ceramics ; Printing, Three-Dimensional ; Tissue Engineering ; Tissue Scaffolds

Chronic diabetic wound remains a critical challenge suffering from the complicated negative microenvironments, such as high-glucose, excessive reactive oxygen species (ROS), hypoxia and malnutrition. Unfortunately, few strategies have been developed to ameliorate the multiple microenvironments simultaneously. In this study, Chlorella sp. (Chlorella) hydrogels were prepared against diabetic wounds. In vitro experiments demonstrated that living Chlorella could produce dissolved oxygen by photosynthesis, actively consume glucose and deplete ROS with the inherent antioxidants, during the daytime. At night, Chlorella was inactivated in situ by chlorine dioxide with human-body harmless concentration to utilize its abundant contents. It was verified in vitro that the inactivated-Chlorella could supply nutrition, relieve inflammation and terminate the oxygen-consumption of Chlorella-respiration. The advantages of living Chlorella and its contents were integrated ingeniously. The abovementioned functions were proven to accelerate cell proliferation, migration and angiogenesis in vitro. Then, streptozotocin-induced diabetic mice were employed for further validation. The in vivo outcomes confirmed that Chlorella could ameliorate the undesirable microenvironments, including hypoxia, high-glucose, excessive-ROS and chronic inflammation, thereby synergistically promoting tissue regeneration. Given the results above, Chlorella is considered as a tailor-made therapeutic strategy for diabetic wound healing.

Objective:To explore the effect of electroencephalographic (EEG) biofeedback combined with buspirone on patients with schizophrenia with anxiety, in order to provide evidence-based reference for clinical treatment.Methods:From January 2018 to January 2020, 80 patients with schizophrenia and anxiety in Jinzhou Kangning Hospital were prospectively selected and divided into the study group and the control group by simple randomization, each group with 40 patients. The control group was given buspirone, and the study group was given EEG biofeedback combined with buspirone. Both were treated for 8 weeks. The efficacy, adverse reactions and the Positive and Negative Symptoms Scale (PANSS) and Hamilton Anxiety Scale (HAMA), the Pittsburgh Sleep Quality Scale (PSQI), Scale of Social Function in Psychosis Inpatients (SSPI), Barthel Index (BI) score, and serum neuroendocrine index thyroid stimulating hormone (TSH), cortisol (Cor) levels before treatment, 4 weeks and 8 weeks after treatment were compared between the two groups.Results:After 8 weeks of treatment, the total effective rate in the study group was higher than that in the control group: 95.0% (38/40) vs. 77.5% (31/40), the difference was statistically significant (χ 2 = 5.16, P<0.05). After 4, 8 weeks of treatment, the PANSS scores in the study group were lower than those in the control group: (49.57 ± 5.65) scores vs. (57.96 ± 6.48) scores, (37.69 ± 4.35) scores vs.(45.07 ± 5.74) scores, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the HAMA and PSQI scores in the study group were lower than those in the control group, while the SSPI and BI scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the serum TSH and Cor levels in the study group were lower than those in the control group: after 4 weeks of treatment: (2.74 ± 0.84) mU/L vs. (3.35 ± 0.97) mU/L, (276.51 ± 45.96) μg/L vs. (346.42 ± 50.34) μg/L; after 8 weeks of treatment: (2.46 ± 0.72) mU/L vs. (2.82 ± 0.86) mU/L, (197.26 ± 36.84) μg/L vs. (264.19 ± 42.46) μg/L, the differences were statistically significant ( P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment ( P>0.05). Conclusions:EEG biofeedback combined with buspirone can enhance the therapeutic effect by regulating neuroendocrine, reduce the mental symptoms, anxiety and sleep disorders ofschizophrenia patients with anxiety. It can also improve social function and daily life ability, and have high safety.

Objective:To explore the relationship of cardiovascular health behavior and factors with development of bone mass loss and postmenopausal osteoporosis in Suxichang area of Jiangsu province.Methods:In the across sectional study, a total of 2 423 postmenopausal women receiving health check-up from March 2019 to June 2020 in our hospital were enrolled.The seven variable factors included cardiovascular health behavior(body mass index, exercise, healthy diet and smoking state)and cardiovascular health-influencing factors(blood pressure, fasting blood glucose and total cholesterol). The information of the seven factors and bone mineral density were recorded.The seven factors were classified as ideal, average and poor, according to the level of bone mineral density.All individuals were divided into three groups: normal bone mass(n=1 305), osteopenia(n=290)and osteoporosis(n=828).Results:There were statistically significant differences in age, fasting blood glucose, systolic blood pressure, diastolic blood pressure, total cholesterol and exercise between osteoporosis and normal bone mass group( P<0.05). As the number of ideal cardiovascular health behaviors and factors increased, the proportion of bone mass loss and osteoporosis gradually decreased( P<0.05). Multiple logistic regression analysis showed that ageing, increased total cholesterol and fasting blood glucose levels were the independent risk factors of osteoporosis.The exercise and normal body mass index were the protective factors for osteoporosis.For each 1 unit increment in age, total cholesterol, body mass index and fasting blood glucose, the OR values for bone mineral density decrement by 1 grade were 1.17, 1.25, 0.92 and 1.23, respectively(all P<0.05). The OR value for bone mineral density decrement by 1 grade was 0.58( P<0.05)when exercise decreased by 1 grade. Conclusions:Postmenopausal women should positively control the levels of total cholesterol and fasting blood glucose, maintain reasonable body weight and conduct regular exercise, which are conductive to the prevention and treatment of postmenopausal osteoporosis.